Medical Research

The U.S. leads the world in biomedical research. The country’s premier research agencies are the National Institutes of Health, which focuses on biological research, and the National Science Foundation, which focuses on breakthroughs in basic sciences. A continued national commitment to investing in these areas is essential for the U.S. to remain at the forefront of medical breakthroughs. 

To accomplish the nation’s research agenda, clinical trials sometimes require the participation of human subjects who require specific protections. 

In addition to research involving human subjects, other promising fields of study involve stem-cell research and genetic research. Like research using human subjects, these approaches raise ethical considerations and are often the subject of controversy. 

The National Institute of Health’s research agenda is broad. Its focus is on preventing and treating common diseases such as cancer. At the same time, it also studies the effectiveness of complementary and integrative medicine such as acupuncture and herbal remedies. 

Cannabis, also known as marijuana, is the name given to the dried buds and leaves of varieties of the Cannabis sativa plant. Scientists have identified many biologically active components in cannabis. These are called cannabinoids. The two most studied components are the chemicals known as THC and CBD. 

As of 2022, more than 37 U.S. states and territories have legalized the medical use of cannabis. State laws vary in several ways. Differences include for what conditions medical use of cannabis is allowed; the amount of cannabis that can be possessed; how, where, and by whom it is allowed to be grown or sold; and other factors. 

The U.S. Drug Enforcement Administration (DEA) lists cannabis and its cannabinoids as Schedule I controlled substances. This means they cannot legally be prescribed, possessed, or sold under federal law. Nonetheless, the Department of Justice has instructed federal prosecutors not to enforce federal marijuana or cannabis laws against companies and individuals acting in accordance with state laws.  

In addition, as of 2019, the U.S. Food and Drug Administration (FDA) has approved one cannabis-derived drug (Epidiolex), which contains CBD. The drug is prescribed for the treatment of seizures associated with epilepsy. 

The National Academy of Sciences, Engineering, and Medicine issued a comprehensive report in 2017, which reviewed the scientific literature supporting the therapeutic and other health effects of cannabis or cannabinoids. The report concluded that there are several clinical problems for which there is conclusive or substantial evidence that cannabis or cannabinoids are effective. These include pain, chemotherapy-induced nausea and vomiting, and patient-reported multiple sclerosis spasticity symptoms. The report also concluded there is moderate evidence that cannabis or cannabinoids are effective for improving short-term sleep outcomes in individuals with sleep disturbances associated with a variety of conditions. The report also noted there is limited or insufficient evidence that cannabis is effective treatment for several other medical conditions. It concluded that there is a need for further research on the health effects of cannabis. The report also mentions that the DEA classification of cannabis as a Schedule I substance impedes the advancement of this research. 

Reducing disparities: It is widely recognized that disparities in service delivery occur by race, ethnicity, age, sex, sexual orientation, and disability status. Experts agree that service-delivery systems, regardless of model, must consider the specific needs of the populations being served. In particular, it is important that systems and providers have the ability to identify and measure disparities so that gaps in care can be identified and addressed. Therefore, it is essential to collect and report performance information that is stratified to determine the existence of disparities. Effective approaches to culturally competent care include the use of community health workers, translation/interpreter services, and practices to ensure a culturally competent workforce. This allows individuals’ preferences, values, and circumstances to be honored. In addition, culturally competent health promotion and education can help members of groups that are discriminated against understand the value of emerging service-delivery models. 

Eliminating racial and ethnic health disparities is a critical matter.  The Affordable Care Act requires all federally conducted or federally supported health programs, activities, or surveys to collect data on race, ethnicity, and primary language, among other things. The Department of Health and Human Services is tasked with devising methods for reporting such data. These data will help the U.S. develop a targeted research agenda designed to reduce health disparities. 

Geroscience is the study of the aging process and how it affects the disease process and susceptibility to disease—and vice versa. More specifically, according to the National Institute on Aging, geroscience seeks to study the “genetic, molecular, and cellular mechanisms that make aging a major risk factor and driver of common chronic conditions and diseases of older people.” 

This exciting and growing field targeting fundamental aging processes might delay, prevent, alleviate, or reverse a wide range of diseases and conditions associated with aging. A National Institute on Aging website notes that “while aging itself isn't a disease, the aging process represents a major risk factor for several chronic diseases and conditions, including frailty and lack of resilience.”  Some researchers focused on the geroscience (aging process) contend that investment and grants focus too much on prevention of and treatment for specific diseases, rather than on the study of these fundamental elements of the aging process itself and this area merits more investment and attention. Nonetheless, clinical trials of interventions designed to slow the biological aging process—and delay or prevent associated disease—are already underway. Many experts do not expect to see initial evidence of positive results for at least 2-3 years and maybe as long as ten or more years for meaningful results, but this area of research if successful has the potential to provide more years of good health as people continue to live longer lives.